Alcohol has long been a significant part of our culture. Go to a social gathering, and it is likely that alcohol will be served, and drinking plays a major role in celebrating special occasions. For most people, drinking is not an issue. In 2014, 87.6 percent of adults over 18 stated they drank at some time in their lives, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Nevertheless, alcohol is an addictive substance, and it presents a problem for many people in the US.

What Is Alcohol Abuse?

Alcohol abuse, more formally termed an alcohol use disorder, is a major problem for many. Not everyone who drinks, of course, is an alcohol abuser, though up to 30 percent of people in the US have abused alcohol at some point in their lives, per WebMD. Most people are moderate, social drinkers, and this type of drinking usually doesn’t develop into a problem. Moderate drinking is typically no more than one drink per day for women and two drinks per day for men, according to NIAAA.

Drinking more than this may define alcohol abuse. Once alcohol abuse takes place on a regular basis, it can indicate an addiction is present. An alcohol use disorder is characterized by a maladaptive drinking pattern that results in negative medical, work, legal, educational, and/or social consequences.

The Effects of Alcohol

Alcohol affects the body and brain in a variety of ways. As a drug, alcohol is a central nervous system depressant. This means that it is a substance that slows the transmission of signals in the brain by affecting the balance of neurotransmitters that relay information throughout the brain. These effects can cause mood and behavior changes, including slowing of motor functions, agitation, depression, memory loss, and seizures.

Alcohol consumption triggers pleasurable, euphoric brain effects and unpleasant brain effects as a negative reaction to symptoms of intoxication. Those who develop an alcohol use disorder typically begin by attempting to recreate the euphoric experiences they associate with drinking. At least part of the toxic effect of drinking is related to the amount of unprocessed alcohol in the brain and body. Additional toxic effects begin when the liver starts to break down alcohol, triggering the accumulation of a poisonous alcohol byproduct called acetaldehyde.

Drinking initiates effects in the brain involving the pleasure center. In spite of unwanted effects from intoxication, those who continue to drink in a maladaptive manner do so as they try to continue to produce those euphoric effects. Excessive drinking leads to having more alcohol in the system than can be properly processed. As the liver breaks down the alcohol, acetaldehyde is produced.

Each individual’s brain responds differently to the effects of alcohol. Among the important factors are how much and how often a person drinks. Other factors can affect the likelihood of an alcohol addiction forming, such as the age at which a person first began drinking and the length of the drinking history along with overall physical health and genetic factors, such as a history of alcoholism in the family.

Signs and Symptoms of Abuse

The symptoms of alcohol abuse differ somewhat according to each individual. General signs of alcohol abuse include:

Preoccupation with drinking

Inability to control drinking

Decreased involvement and interest in usual activities

Loss of interest in family or friends

Depression

Restlessness

Erratic or violent behavior

Someone with an alcohol use disorder continues to drink in spite of these harmful consequences.

How Alcohol Abuse, Addiction, and Dependence Happen

While there isn’t a single cause for addiction, several factors come into play. These include genetics, how a person was raised, social environment, and mental and physical health. Those with a positive family history of alcohol addiction are more likely to develop alcohol addiction themselves. Those with mental health problems, such as anxiety, depression, or bipolar disorder, are at high risk for addiction issues because they may use alcohol to self-medicate their mental health symptoms. In addition, peer pressure and other environmental factors make it more likely that someone will abuse and subsequently become addicted to alcohol.

Dependence develops with continued use. The longer time a person abuses alcohol, the more the nervous system adjusts to its effects, leading to an increased tolerance for it. Larger and larger quantities of alcohol are therefore required to produce the same effects. Over time, this can turn into alcohol dependence. With alcohol dependence, not drinking for even a relatively short time can lead to withdrawal symptoms. The body has grown accustomed to alcohol’s presence and feels it needs it to feel “normal.”

Some of the symptoms seen with alcohol withdrawal are:

Anxiety

Irritability

Insomnia

Shaky hands

Sweating

Muscle tension

Chest tightness

Headache

Nausea and vomiting

Heart palpitations

For those who develop a chronic alcohol dependence issue, there can be life-threatening long-term effects. Chronic excessive alcohol consumption can negatively affect almost every organ system. Specific effects on the body include the following:

Poor nutrition

Cardiovascular consequences, like hypertension or irregular heartbeat

Thiamine deficiency

Gastrointestinal disorders, such as jaundice, cirrhosis of the liver, and pancreatitis

Drastic impact on the brain, such as stroke, confusion, and memory loss

In a small percentage of people, alcohol withdrawal may trigger delirium tremens (DTs), a potentially life-threatening withdrawal syndrome. Symptoms of DTs include body tremors, hallucinations, extreme mood changes, and seizures. DTs is considering a medical emergency, and immediate medical attention is needed.

Due to the potential for life-threatening withdrawal symptoms, medical detox is always needed for alcohol withdrawal. This ensures individuals are safe throughout the entire detox process.

Statistics on Alcohol Abuse, Binge Drinking, and Alcohol Use Disorders

According to NIAAA, in 2014, approximately 16.3 million or 7 percent of adults suffered from an alcohol use disorder. This number includes 5.7 million women and 10.6 million men. Among adolescents aged 12-17, it was projected that 679,000 experienced an alcohol use disorder.

Per the Centers for Disease Control and Prevention, binge drinking is drinking with the intention of becoming intoxicated. It is generally characterized by consuming at least five drinks in a two-hour period for men and at least four drinks in that time period for women. Binge drinking significantly increases the likelihood of developing alcohol dependence. In 2014, NIAAA statistics showed that 24.7 percent of adults 18 and up indicated they binge drank during the previous month.

The Impact of Alcohol Abuse

Often, those suffering from alcohol abuse or addiction do not realize their drinking has become a problem. After all, with the often gradual, insidious progression of addiction, it’s common for those who are affected by this disease to continue to believe they remain more functional than they actually are, which is called denial.

When thinking of someone with an alcohol addiction, a picture may come to mind of a person who regularly engages in heavy drinking episodes. The vision may be of someone with financial problems, broken relationships, difficulty maintaining a job, and overt health problems.

For at least 20 percent of those with an alcohol use disorder, this is not an accurate picture. Instead of being unemployed and homeless, functional alcoholics tend to be well-educated with a family and a successful career. They may work a regular schedule, carry out daily activities, and drink heavily late in the day. Others may see them as normal. Despite the ability of functional alcoholics to maintain “normal” life function, consequences of the ongoing alcohol abuse generally begin to appear over time. In addition, health problems often begin to bubble under the surface as a result of the chronic drinking.

Chronic alcohol abuse creates significant mental and emotional trauma on spouses and families of those who abuse alcohol. Divorce rates in couples where at least one spouse drinks are much higher than average. Resentment is common in these relationships. These relationships suffer from:

Poor communication

Increased anger and stress

Reduced intimacy

Increased marital abuse

Depleted finances due to money spent on alcohol

Ultimately, it may be the enormous stress that alcohol abuse brings to the family unit that precipitates the person seeking treatment.

Getting Help

Oftentimes, those struggling with alcohol abuse may need to be confronted with the negative effects of their behavior. This discussion can be challenging, often due to anger, anxiety, guilt, and shame that is related to the abuse and its effects. When approaching a loved one, it’s important to be empathetic and caring. Here are some tips to facilitate the conversation:

Educate yourself on addiction and recovery so you know how to speak knowledgeably on the subject.

Let your loved one know you are concerned, and outline the impact the drinking is having on them and the family.

Do not accuse or judge the person. Addiction isn’t anyone’s fault.

Encourage the person to seek professional help. Ideally, pick out a treatment program beforehand to present to your loved one during the conversation.

Set healthy boundaries. If the person doesn’t agree to get help, there may be consequences, such as you might withdraw financial support. Be ready to stand firm on the consequences you outline.

Enlist the help of a professional. These conversations can be difficult, and more positive outcomes may result if a professional aids the process. An interventionist or family mediator can facilitate the conversation.

Medications and Therapies Used to Treat Alcohol Abuse

As stated, medical detox is needed to withdraw from alcohol. Medically assisted detox typically involves the use of specific medications to moderate dangerous physical withdrawal symptoms and help to prevent relapses. Several medications have been approved by the FDA for this purpose, including Antabuse, naltrexone, and Campral.

In addition to medical detox treatment, comprehensive therapy is needed. While various forms of therapy may be used, certain types have been shown to be effective in treating alcohol addiction. Cognitive Behavioral Therapy (CBT) focuses on identifying and modifying negative thought patterns. Motivational Enhancement Treatment (MET) helps those with alcohol addiction address their motivation to change and develop a personal plan to achieve those changes. A 12-Step model of recovery, such as that used in Alcoholics Anonymous, has also been shown to be effective.

Oftentimes, taking the first step of seeking help is the hardest. Without proper help, alcohol abuse and addiction can result in life-threatening effects for the drinker and have a serious impact on those around the person. But with professional help, complete recovery is within reach.

Individuals who complete addiction treatment are more likely to:

Achieve sobriety

Have fewer legal problems

Experience fewer relapses

Have better relationships with family, friends, and coworkers

Finding a Treatment Facility

There are a variety of treatment facilities available that serve clients on both an inpatient and outpatient basis. The determination between inpatient and outpatient treatment is made on an individual basis and dependent on the severity of the client’s abuse patterns, the person’s home environment, past history with substance abuse, and any co-occurring physical or mental health issues. There are many options available to establish a healthy foundation for recovery, enabling individuals to leave balanced, happy lives without the need for alcohol.